Good
afternoon MM:
I'm glad to hear that you've got an appointment
booked to get some answers, and possibly some
diagnoses! You have no greater weapon at your
disposal than knowledge, and educating yourself
more in TS and the various disorders that can
co-occur with it is your best and most multi-faceted
offence and defence wrapped all in one! There
is a lot you can learn and do to inform yourself
before February: read my website, link from mine
to others, join internet chatrooms, go to support
group meetings in your area, and empower yourself
and your son by doing so.
While
I am not in a position to make any diagnostic
statements, I can say that it is very common for
children with TS to have elements of ADHD -- some
studies suggest upwards of 90% of children at
least have some SYMPTOMS of ADHD. From your description,
it sounds like there may be elements of hyperactivity
and impulsivity in your son and you should be
sure to bring these symptoms to the attention
of the neurologist when you go for the February
appointment.
Regarding
your son not seeming to "hear" you when
he's being silly: when a child IS acting on impulse
or is running on excess energy, oftentimes (s)he
can 'miss' the signs we are sending out that "we've
had enough -- we're starting to boil and you will
be in trouble soon"). While obvious to us,
nonverbal cues such as tone, body language, and
facial expression may be too subtle to be noticed
by the overstimulated child. Being more explicit
with the child about how you are feeling before
reaching the boiling point or even explicitly
training the child in how to watch for signs of
irritation in others (e.g., "see my face
right now Timmy? This is my angry face. When you
see this face it means I'm probably going to yell
soon") can help.
Of
course, you are wrong about being a horrible mother
because of how your son acts and how you sometimes
react! These disorders DO have neurological bases
to them -- you didn't "do" this to him.
And you would not be human if you DIDN'T sometimes
get frustrated with the extremes we disinhibited
people can take you to. In fact, you should take
the fact that he acts out in front of you and
not at school as a warped sort of compliment.
There is some control possible in these disorders
as to when you "release" (akin to deciding,
with limited success, when you will scratch an
itch) and people tend to release in the environments
where they feel the "safest" and most
comfortable. Left with little options around WHETHER
his symptoms will come out, he chooses (somewhat)
WHERE they will come out and in so doing basically
says, "I KNOW you love me, mommy, and won't
lock me up and throw away the key because I'm
strange or different".
I hope this helps. Happy learning MM -- you are
taking the first steps in one of the most important
journeys you and your son will ever embark upon.
Dr. Dunc.
